Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JORDAN LEE WALLIN, M.D.
Active Sole ProprietorDR. JORDAN LEE WALLIN, M.D. is a Facial Plastic Surgery healthcare provider located in ST GEORGE, Utah. NPI 1811177652 is currently active in the NPPES registry. Verify at CMS.
Facial Plastic Surgery · ST GEORGE, UT
Registration Details
- NPI Number
- 1811177652
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 9, 2007 (18.77200604477 yrs)
- Last Updated
- Jan 2, 2025
- License
-
11043029-1205 (UT)
- Sole Proprietor
- Yes
Practice Information
- Address
-
446 S MALL DR STE B1ST GEORGE, UT, 847904945Browse UT providers · Browse ZIP 84790
- Phone
- 4356278150
- Fax
- 4355804028
- Primary Specialty
-
Facial Plastic Surgery
207YX0905X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.